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CVD medication usage of older patients heavily influenced by adverse effects
Fried T. Arch Intern Med. 2011;doi:10.1001/archinternmed.2011.32.
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Researchers of a new study have found that the willingness of older patients to take medication for primary CVD prevention was highly sensitive to the medication's potential adverse events and relatively insensitive to its benefits.
“The findings in this study regarding variability in willingness to take medication according to its benefit are consistent with the results of earlier investigations,” the researchers wrote. “This study further demonstrated that changing the absolute benefit provided by the medication affected the willingness only of a small proportion of people unless the change in absolute benefit was substantial.”
The study involved 356 community-dwelling older participants (mean age, 76 years) who were questioned in a face-to-face interview about their willingness to medication to prevent MI. All volunteers were included in the study without exclusion.
According to study data, most participants (88%) were willing to take a medication that provided a 30% relative reduction in MI risk (six fewer people with MI out of 100) if there were no adverse events, with the percentage of willing patients increasing as the absolute benefit of the medication increased. The reasons those in the initial scenario turned down medications included the belief that the benefit was too small (n=13), belief that medication would have adverse effects (n=13) and an overall dislike of medications (n=7).
Of those who would take medication, 82% remained willing if the absolute benefit was decreased to three fewer people with MI. Conversely, medications with average benefit but that caused mild fatigue, fuzzy thinking and nausea would be turned down by 48% to 69% of the study population, whereas only 3% would take medications with severe enough effects to affect functioning.
These results, the researchers concluded, “suggest that clinical guidelines and decisions about prescribing these medications to older persons need to place emphasis on both their benefits and harms.”
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